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Organization
COVENANT HEALTHCARE, LLC
Active
Organization
COVENANT HEALTHCARE, LLC
Active
Other names
Dove Healthcare - West
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES P. DEIGNAN NHA, CPA (EXECUTIVE DIRECTOR/CEO)
(715) 552-1030
Entity
Organization
Contact information
Practice address
1405 TRUAX BLVD, EAU CLAIRE, WI 54703-1474
(175) 552-1030
(715) 552-1033
Mailing address
1405 TRUAX BLVD, EAU CLAIRE, WI 54703-1474
(175) 552-1030
(715) 552-1033
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3195
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20178200
—
WI
05
—
3195
—
WV
05
—
41480100
—
WI
Enumeration date
07/19/2005
Last updated
11/18/2011
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